TITLE: Prevalence of Social Anxiety among Students in

TITLE:
Prevalence of Social Anxiety among Students in Medical College

 

Introduction:
       

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            Social Anxiety Disorder (SAD) is
highly prevalent in both clinical settings and as well as community samples. In
community samples SAD considered as the second most frequent anxiety disorder
after specific phobia that attained prevalence rates of 13% (Kessler,
McGonagle, Zhao et al., 1994). Another community study in Switzerland reported
even higher lifetime estimates of social phobia than the NCS did 16 percent
(Wacker, Müllejans, Klein, & Battegay, 1992). In Sweden, Furmark and
colleagues (1999) further supported that social phobia is among the most common
mental disorders when they in a community survey noted a point prevalence of
15.6 percent.

            Coming to onset, it typically begins
as early as adolescence or early adulthood (Hazen, 1995 & Ost, 1987). The characteristics
feature of SAD is excessive and persistent fear of social situations in which
the patient is exposed to the observation or scrutiny of others.

The field
of medicine is very vast and inherently stressful to pursue. Students in
medical college work with high workload, beyond their duty hours very often
compromising their sleep and social activities. Still there is high level  competition and social support for them is
very little. All of these contributes to medical student’s stress & their
deterioting mental health (Dyrbye, Thomas, & Shanafelt, 2006). It affects physical health, academic
performance, social interaction in a negative way.

 

Rationale
:

            Inspite of this high prevelance, in
our clinical experience, we are not seeing it as much as other mental health
disorders. Perhaps, one of the main reasons is the lack of awareness in
community sample about this condition and whether it needs a professional help
or not.

            It’s impairment is substantial
(Schneier, 1992 & Davidson, 1993). Critical social impairments usually
develop between the ages of fifteen and twenty-five, among both males and
females (Piet, Hougaard, Hecksher, & Rosenberg, 2010). Functional
impairment associated with it may be severe (Rapee, 1995). Social interation
fears (e.g, interaction with strangers, authority figures, dating), performance
fears (e.g, test anxiety, public speaking) and observation fears (e.g, working
in front of others, eating before others and etc) are common. Above noted
impairments and complication can even extend to inability to
work, attend school, or marry which are very common (Wacker, 1992; Furmark,
1999 & Zaider, 2003).

            SAD, again, is usually complicated
by work absenteeism, drug and/or anxiolytics abuse, alcoholism and depression
(Barlow, DiNardo, Vermilyea and Blanchard, 1986; Bowen, Cipywnyk, D’Arcy and
Keegan, 1984; Chambless, Cherney, Caputo and Rheinstein, 1987; Higgins and
Marlatt, 1975; Kushner, Sher and Beitman, 1990; Schneier, Martin, Liebowitz et
al., 1989). In some cases these problems are the expression of an undiagnosed
social phobia, so that the prevalence of this clinical condition may be greater
than estimated (Stravynski, Lamontagne and Lavallee, 1986).

            Hence the present study can uncover
the unidentified cases of SAD in student samples and can benefit them in
guiding them for seeking effective required management options and may save
them from the associated impairments of it.

Objective :

1. To measure magnitude of social anxiety across
various year in MBBS.

Implications :

1.     
We will know the prevalance of SAD in medical college as per
the different batches/years.

2.     
Awareness of such may push for early intervention.

3.     
It further leads to decrease of various associated
impairments like stress, depression, insomnia, pain attacks etc.

4.     
Increase in work productivity, coping with stress &
increase in social interaction.

5.     
Overall we can expect a better mental health status.

Methodology :

Research Design: Cross
Sectional Study

Sample: Participants
will be randomly selected from students of SCB Medical College, Cuttack.

Materials: Apart from
Socio- Demographic Data Sheet, the screening tool will be Social Phobia Inventory (SPIN: Connor et al., 2000), a 17-item self-report measure of fear and avoidance of a
range of social situations and of physiological symptoms of anxiety. The SPIN
has been validated for use in clinical populations, has strong convergent and
discriminant validity, and good internal consistency and test-retest reliability (Antony, Coons,
McCabe, Ashbaugh, & Swinson, 2006);Alphas
ranged from .88 to .92 across the four assessment points in the present study.

 

Data Analysis: Appropriate statistical analysis will be
done.

 

References :

1.     
Antony, M. M., Coons, M. J., McCabe,
R. E., Ashbaugh, A., & Swinson, R. P. (2006). Psychometric properties of
the social phobia inventory: Further evaluation. Behaviour research and
therapy, 44(8), 1177-1185.

2.     
Connor, K. M., Davidson, J. R.,
Churchill, L. E., Sherwood, A., Weisler, R. H., & FOA, E. (2000).
Psychometric properties of the social phobia inventory (SPIN). The British
Journal of Psychiatry, 176(4), 379-386.

3.     
Dyrbye, L. N., Thomas, M. R., & Shanafelt,
T. D. (2006). Systematic review of depression, anxiety, and  other indicators of psychological distress
among US and Canadian medical students. Academic Medicine, 81(4),
354-373.

4.     
Furmark, T., Tillfors, M., Everz, P.
O., Marteinsdottir, I., Gefvert, O., & Fredrikson, M. (1999). Social phobia
in the general population: prevalence and sociodemographic profile. Social
psychiatry and psychiatric epidemiology, 34(8), 416-424.

5.     
Hazen
AL, Stein MB. Clinical phenomenology and comorbidity. In: Stein MB, ed. Social
Phobia: Clinical and Research Perspectives. Washington, DC: American
Psychiatric Press; 1995:3-41.

6.     
Kessler
RC, McGonagle KA, Zhao S, Nelson CB, Hughes M, Eshleman S, Wittchen H-U,
Kendler KS. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders
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Psychiatry. 1994;51:8-19.

7.     
 O¨ st L-G. Age of onset in different phobias.
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8.     
Piet, J., Hougaard, E., Hecksher, M.
S., & Rosenberg, N. K. (2010). A randomized pilot study of mindfulness-based
cognitive therapy and group cognitive-behavioral therapy for young adults with
social phobia. Scandinavian
Journal of Psychology, 51, 403-410.

9.     
Rapee, R. M. (1995). Descriptive
psychopathology of social phobia. Social phobia: Diagnosis, assessment, and
treatment, 41-66.

10.   Reich J, Goldenberg I, Vasile R, Goisman R,
Keller M. A prospective followalong study of the course of
social phobia. Psychiatry Res. 1994;54:249-258.

11.   Schneier FR, Heckelman LR, Garfinkel R,
Campeas R, Fallon BA, Gitow A, Street L, DelBene D, Liebowitz MR. Functional
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12.  Schneier FR, Johnson
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13. 
Stravynski, A., Lamontagne, Y.,
& Lavallée, Y. J. (1986). Clinical phobias and avoidant personality
disorder among alcoholics admitted to an alcoholism rehabilitation setting. The
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14. 
Wacker, H. R., Mullejans, R., Klein,
K. H., & Battegay, R. (1992). Identification of cases of anxiety disorders
and affective disorders in the community according to ICD-10 and DSM-III-R by
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Psychiatr Res, 2, 91-100.

15. 
Zaider, T. I., Heimberg, R. G.,
Fresco, D. M., Schneier, F. R., & Liebowitz, M. R. (2003). Evaluation of
the clinical global impression scale among individuals with social anxiety
disorder. Psychological medicine, 33(04), 611-622.

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